Systemic review/Meta-analysis Clinical efficacy and safety of colistin treatment in patients with pulmonary infection caused by Pseudomonas aeruginosa or Acinetobacter baumannii : a meta-analysis

Zhang, Huagen; Zhang, Qianyun

doi:10.5114/aoms.2015.48158

Cited by 15 publications

(11 citation statements)

References 38 publications

(46 reference statements)

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“…Colistin has their antimicrobial activity mainly directed against the bacterial cell membrane results in an increase in the permeability of the cell membrane, leakage of cell contents, and ultimately cell death [20]. Colistin sulfate and colistimethate sodium (also known as colistin methanesulfonate [CMS]) are commercially available forms of this drug [21, 22]. However, the use of colistin has been limited due to significant nephrotoxicity and neurotoxicity and reports showed resistance to colistin [21, 22].…”

Section: Introductionmentioning

confidence: 99%

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In vitro activities of colistin, imipenem and ceftazidime against drug-resistant Pseudomonas aeruginosa and Acinetobacter baumannii isolates in the south of Iran

et al. 2019

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Objective The present study aimed to determine in vitro activity of colistin and other agents against drug-resistant isolates of Pseudomonas aeruginosa and Acinetobacter baumannii . Results This in vitro study performed on a collection of non-fermenting Gram-negative bacilli (NFB) consist of 18 A. baumannii and 21 P. aeruginosa isolates. Non-duplicated isolates (one per patient) were isolated from blood, endotracheal tube and sputum samples of hospitalized patients in the south of Iran. The minimum inhibitory concentrations (MICs) of each isolate was determined using Epsilometer (E)-test strips containing colistin, imipenem, and ceftazidime. In overall, all A. baumannii isolates were non-susceptible to imipenem and ceftazidime. In contrast, all isolates were susceptible to colistin with MIC50 and MIC90 of 0.75/1.5 µg/mL, respectively. Antibiotic susceptibility results showed that 81% and 23.8% of P. aeruginosa isolates were susceptible to ceftazidime and imipenem, respectively. While, all of the P. aeruginosa isolates were susceptible to colistin with MIC50 and MIC90 of 0.5/1 µg/mL, respectively. In summary, colistin showed the promising in vitro activity against drug-resistant strains of two clinically important NFB in our region. However, investigation on a larger collection of drug-resistant strains demands to support these observations in the near future.

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Section: Introductionmentioning

confidence: 99%

“…Colistin sulfate and colistimethate sodium (also known as colistin methanesulfonate [CMS]) are commercially available forms of this drug [21, 22]. However, the use of colistin has been limited due to significant nephrotoxicity and neurotoxicity and reports showed resistance to colistin [21, 22].…”

Section: Introductionmentioning

confidence: 99%

In vitro activities of colistin, imipenem and ceftazidime against drug-resistant Pseudomonas aeruginosa and Acinetobacter baumannii isolates in the south of Iran

et al. 2019

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“…Parenteral polymyxin E or colistin has been used in the form of colistimethate sodium (CMS), an inactive prodrug of colistin that requires conversion to its active form after administration 4. The effectiveness of CMS for XDR Gram-negative infections was modest with a cure rate of 30%–75%, an overall mortality rate of 15%–60% and nephrotoxicity occurring in 10%–60% of cases 5–7…”

Section: Introductionmentioning

confidence: 99%

Effectiveness and safety of polymyxin B for the treatment of infections caused by extensively drug-resistant Gram-negative bacteria in Thailand

Ngamprasertchai¹,

Boonyasiri²,

Charoenpong³

et al. 2018

IDR

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BackgroundColistimethate sodium (colistin) has been used in the treatment of infections caused by extensively drug-resistant (XDR) Gram-negative bacteria in Thailand over the past decade, with a mortality rate of 50% and a nephrotoxicity rate of 40%. Polymyxin B has not been available in Thailand. We conducted a Phase II clinical study to determine the effectiveness and safety of polymyxin B, compared with colistin, for the treatment of XDR Gram-negative bacterial infections in Thai patients.MethodsA total of 73 adult patients hospitalized at four participating tertiary care hospitals from January 2015 to December 2015 who had infections caused by XDR Gram-negative bacteria and had to receive colistin were enrolled in the study. Polymyxin B (100 mg/day) was administered intravenously every 12 hours for 7–14 days.ResultsMost of the patients were older males with comorbidities who had received antibiotics, particularly carbapenems, prior to receiving polymyxin B. More than half of the patients had pneumonia, and 51.5% of the infections were caused by XDR Acinetobacter baumannii, which was susceptible to colistin. Good clinical responses at the end of treatment were observed in 78.1% of cases, the overall 28-day mortality rate from all causes was 28.7%, the microbiological clearance of the targeted bacteria after therapy was 56.2% and nephrotoxicity occurred in 24.7% of cases. Neurotoxicity relating to reversible numbness was observed in two cases.ConclusionPolymyxin B seems to be effective and safe for the treatment of XDR Gram-negative bacterial infections. Polymyxin B should be considered as an alternative to colistin for treatment of infections caused by XDR Gram-negative bacteria in Thai adult patients, especially those at risk of nephrotoxicity.

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“…The medical community is in need of more therapeutic approaches, beyond colistin, as the exclusive administration and overuse of one antimicrobial class will inevitably limit the susceptible bacterial population, thus nullifying one more last-resort agent. Therefore, the evidence of using alternative therapeutic agents (alone or in combination) for A. baumannii infections like tigecycline, colistin, and sulbactam-based regimens should not be overlooked [86,87,88,89]. Minocycline is unique among the currently available therapeutic options against MDR A. baumannii in that it can be administered orally.…”

Section: Discussionmentioning

confidence: 99%

The Role of Minocycline in the Treatment of Nosocomial Infections Caused by Multidrug, Extensively Drug and Pandrug Resistant Acinetobacter baumannii: A Systematic Review of Clinical Evidence

et al. 2019

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Treatment options for multidrug resistant Acinetobacter baumannii strains (MDR-AB) are limited. Minocycline has been used alone or in combination in the treatment of infections associated with AB. A systematic review of the clinical use of minocycline in nosocomial infections associated with MDR-AB was performed according to the PRISMA-P guidelines. PubMed-Medline, Scopus and Web of Science TM databases were searched from their inception until March 2019. Additional Google Scholar free searches were performed. Out of 2990 articles, 10 clinical studies (9 retrospective case series and 1 prospective single center trial) met the eligibility criteria. In total, 223 out of 268 (83.2%) evaluated patients received a minocycline-based regimen; and 200 out of 218 (91.7%) patients with available data received minocycline as part of a combination antimicrobial regimen (most frequently colistin or carbapenems). Pneumonia was the most common infection type in the 268 cases (80.6% with 50.4% ventilator-associated pneumonia). The clinical and microbiological success rates following minocycline treatment were 72.6% and 60.2%, respectively. Mortality was 20.9% among 167 patients with relevant data. In this systematic review, minocycline demonstrated promising activity against MDR-AB isolates. This review sets the ground for further studies exploring the role of minocycline in the treatment of MDR-AB associated infections.

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Systemic review/Meta-analysis Clinical efficacy and safety of colistin treatment in patients with pulmonary infection caused by Pseudomonas aeruginosa or Acinetobacter baumannii : a meta-analysis

Cited by 15 publications

References 38 publications

In vitro activities of colistin, imipenem and ceftazidime against drug-resistant Pseudomonas aeruginosa and Acinetobacter baumannii isolates in the south of Iran

In vitro activities of colistin, imipenem and ceftazidime against drug-resistant Pseudomonas aeruginosa and Acinetobacter baumannii isolates in the south of Iran

Effectiveness and safety of polymyxin B for the treatment of infections caused by extensively drug-resistant Gram-negative bacteria in Thailand

The Role of Minocycline in the Treatment of Nosocomial Infections Caused by Multidrug, Extensively Drug and Pandrug Resistant Acinetobacter baumannii: A Systematic Review of Clinical Evidence

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